NPI | 1952807935 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD480657) |
Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: PA MD480657) |
Enumeration Date | 2018-03-30 |
Last Update Date | 2023-12-21 |